The high cost of data entry is a critical issue that has challenged the evolution of computerized patient record systems. Development of dynamic language models is proposed for significantly improving the cost performance of medical transcription systems. The innovative use of speech recognition, computer telephony integration, and the Internet is proposed for the management and transcription of physician dictation. Results of Phase I research demonstrate significant cost savings to healthcare organizations. Our goal in Phase II is to apply multiple dynamic language models to both improve accuracy and the robustness of the system. We propose to create a physician specific mapping of historical transcriptions to their spoken counterparts. We then propose to explore different methodologies for building language models for specific physician work-type combinations using a database of processed historical transcriptions based on dictations from over 1,500 physicians. In addition, the output of the recognition system will be processed by a natural language processing engine to transform it into a formatted, styled draft transcription for review and editing by a transcriptionist. Our unique approach integrates seamlessly into a physician's workflow and does not require the alteration of physician work patterns. We expect this research and development will result in a commercially viable transcription system that significantly reduces costs associated with medical transcription. eScription has obtained three paying pilot customers with whom we are working closely with to develop this system. These customers have/will provide eScription with textual data, audio data, and medical transcriptionists who will test the final system. All have expressed a keen interest in becoming corporate partners for Phase III. Two are currently using our prototype system in their production environments today. We are submitting this grant request to partially cover the cost of constructing and testing the system. PROPOSED COMMERCIAL APPLICATIONS: eScription focuses on alleviating significant healthcare cost pressures associated with transcription of medical dictation. We apply new technologies such as speech recognition, computer telephony and Internet communications, which are not commonly used for medical transcription. We will directly sell our software products and services to Integrated Delivery Networks (IDNs) and to Transcription Services Companies.